Eye最新文献

This systematic review and meta-analysis examined the proportion of primary angle closure suspects (PACS) progressing to primary angle closure (PAC), acute angle closure (AAC), and primary angle closure glaucoma (PACG) and evaluated the impact of prophylactic laser peripheral iridotomy (LPI) on disease progression. A systematic search was performed on MEDLINE and EMBASE for studies published until November 2023 that reported on the proportion of PACS progressing to PAC. Using random-effects modelling, risk ratios and 95% confidence intervals estimated the proportion of progressing PACS between patients who received LPI versus those who did not. Two randomized-controlled-trials and three observational studies included a total of 1997 PACS patients. The weighted average age was 57.2 years with 74.7% females, and an average follow-up period of 6.2 years. Overall, 284 (14.2%) PACS patients progressed to either PAC (n = 258, 12.9%), AAC (n = 9, 0.5%), or PACG (n = 17, 0.9%). Patients receiving LPI displayed a 2.49-fold decrease in the risk of progression to PAC (RR: 2.49; 95% CI = 1.50-4.07; p < 0.001; NNT = 15), suggesting that there is a higher risk of disease progression without LPI. However, for the progressions to AAC and PACG, statistical significance was not reached. The present study provides valuable insights to the proportion of PACS who showed disease progression and underscores the potential benefit of prophylactic LPI in reducing the risk of angle closure disease progression. However, this study also addresses the issues surrounding the lack of demonstrated clinical efficacy for this intervention, thus advocating for a balanced approach in clinical decision-making.

Purpose: To present functional and anatomical outcomes of subretinal therapy with Voretigene Neparvovec (VN) in patients treated in one of the four specialist UK gene therapy centres.

Methods: Single-centre, retrospective case series of patients affected by an inherited retinal dystrophy (IRD) caused by a pathogenic biallelic RPE65 mutation and treated with VN. Complete ophthalmic examination was planned preoperatively and 2, 4 and 8 weeks and 3, 6, 12, 18 and 24 months after surgery, and included visual acuity (VA) assessment (normal and low luminance), colour vision, contrast sensitivity, dark-adapted full-field stimulus threshold, macular optical coherence tomography (OCT) and fundus autofluorescence.

Results: Fourteen eyes of 8 patients were included with a mean follow-up of 26 months. Mean final VA improved by 2 lines, and improvements were noted in most other functional tests. Central retina thickness (CRT) remained fairly stable in the majority of patients, whereas 2 eyes experienced a reduction >30 μm. The status of ellipsoid band and external limiting membrane remained stable in all patients, except one. Peripapillary atrophy (PPA) was present in 5 eyes of 3 patients at the baseline; postoperative progression was noted in both eyes of one patient. No patient developed new PPA or chorioretinal atrophy (CRA) involving the macular area after treatment. Five eyes of 3 patients developed CRA at the retinotomy site, that progressed in 3 of them.

Conclusions: Our study confirmed the effectiveness of subretinal VN therapy in terms of improvement of visual function. CRA was confirmed as a common postoperative complication, with limited functional impact.